The White House has announced (no link yet) thirteen winners of the 2011 Presidential Citizens Medal, the nation’s second-highest civilian honor. Included among the thirteen honorees is Janice Langbehn, who was denied access to her partner, Lisa Pond, as she lay dying in a Florida Hospital in 2007. The White House statement honoring Janice reads:

Janice Langbehn, Lacey, WAWhile on vacation with her family in February 2007, Janice Langbehn’s partner, Lisa Pond, suddenly fell ill and was rushed to the hospital. Langbehn was refused access to her partner, who had experienced a brain aneurysm and later died alone. With the help of Lambda Legal and GLAAD, she filed a federal lawsuit and worked to get her story out to the nation. Janice’s story received attention from President Obama, who personally apologized to her for the way she and her family was treated. He went on to revise hospital visitation rights for gay and lesbian couples, which went into effect this past January for any hospitals receiving federal Medicare or Medicaid funds. Langbehn receives the Citizens Medal for her efforts to ensure all Americans are treated equally.

The Department of Health and Human Services unveiled new guidance this morning to ensure compliance to new HHS policies designed to enhance hospital visitation rights for same-sex couples. The Centers for Medicare and Medicaid sent letters to states outlining additional enforcement mechanisms for the new policies announced last year which require that medical facilities accepting Medicare or Medicaid funds allow patients to designate their own visitors during hospital stays and recognize advance directives designating a same-sex partner for making emergency medical decisions. The letter to state auditing agencies outlines guidance on ensuring compliance with the new policies, and marks the last step in implementing the policy change.

The policy change announced last year affected rules and regulations for safety and quality of health care that hospitals must meet before qualifying to receive Medicare and Medicaid funds. Because those rules apply to the hospital’s operating procedures as a whole, the policy change applies to all hospital patients, not just those whose care is paid for by Medicare or Medicaid.

In announcing the new guidance for enforcing the rules, HHS Secretary Kathleen Sebelious said, “Couples take a vow to be with each other in sickness and in health and it is unacceptable that, in the past, some same-sex partners were denied the right to visit their loved ones in times of need. We are releasing guidance for enforcing new rules that give all patients, including those with same-sex partners, the right to choose who can visit them in the hospital as well as enhancing existing guidance regarding the right to choose who will help make medical decisions on their behalf.”

One of the saddest indignities that gay couples suffer is when hospitals deny them the comfort of love amidst serious illness. Using definitions of “family” that elevate an estranged third-cousin above a decades-long partner, “rules and procedures” can actually result in emotional torture to a sick person who is forced to die alone while administrators lock their spouses and children away from them as though they were nosy interloping strangers.

Fortunately, most people aren’t cruel. And even many of the most stalwart “defenders of the family” will concede that people should be able to be with their partners in the hospital. In fact, when President Obama required that those hospitals that receive Medicare funding revisit their policies to allow patients, not pencil-pushers, to define their family, few complained about “the homosexual agenda.”

I say “few” and not “none” because some folk can be counted on to react negatively, even to the most benign of ideas. Anything whatsoever that might possibly be considered to benefit a gay person will evoke a Pavlovian response. Gay marriage – hate it. Gay military service – fight it. Gay apparel – won’t don it. Gay ol’ Time – not for a minute.

One such pillar of predictability is Matt Barber, the Associate Dean of Liberty University School of Law. Yes, Matt can be counted on to scoop up a big steaming pile of nastiness and throw it at our community. And the issue of having your loved ones in the hospital with you is no exception.

Now Matt, who just isn’t all that bright (no, I’m sorry, it’s not just his opinions – the guy really is stupid) makes the following argument:

* You can have any visitors you like
* So no one is discriminating against gay people
* But allowing gay people to have their partners visit is unfair to Catholic and Baptist hospitals who don’t want to allow gay visitors

Yes, Barber literally makes an argument for denying gay sick people to have their partners visit. He thinks – and I kid you not – that hospitals should have the “liberty of conscience” to emotionally torture their patients.

“Certainly there are Catholic hospitals and Baptist hospitals that recognize homosexual behavior as sinful behavior,” he points, “and they do not want to take part in affirming homosexual sin under the strong arm of the government.”

Some religious hospitals may have to make a decision as to whether to conform to the rules or not accept Medicare patients. Barber says what the Obama administration is doing is casting liberty of conscience aside and forcing acceptance of homosexuality.

It’s no wonder that when I read Matt Barber’s name, I find myself whistling:

When then-candidate Barack Obama accepted the Democratic Party’s nomination, he only made one LGBT-related commitment in his acceptance speech:

I know there are differences on same-sex marriage, but surely we can agree that our gay and lesbian brothers and sisters deserve to visit the person they love in the hospital and to live lives free of discrimination.

Today, President Barack Obama followed through on that commitment. Today he issued a Presidential Memorandum ordering ordered the Secretary of Health and Human Services (HHS) to issue new rules requiring hospitals who receive Medicare and Medicaid payments to provide visitation rights to same-sex partners, and to make it easier for gays and lesbians to make medical decisions on behalf of their partners.

[E]very day, all across America, patients are denied the kindnesses and caring of a loved one at their sides — whether in a sudden medical emergency or a prolonged hospital stay. Often, a widow or widower with no children is denied the support and comfort of a good friend. Members of religious orders are sometimes unable to choose someone other than an immediate family member to visit them and make medical decisions on their behalf. Also uniquely affected are gay and lesbian Americans who are often barred from the bedsides of the partners with whom they may have spent decades of their lives — unable to be there for the person they love, and unable to act as a legal surrogate if their partner is incapacitated.

For all of these Americans, the failure to have their wishes respected concerning who may visit them or make medical decisions on their behalf has real consequences. It means that doctors and nurses do not always have the best information about patients’ medications and medical histories and that friends and certain family members are unable to serve as intermediaries to help communicate patients’ needs. It means that a stressful and at times terrifying experience for patients is senselessly compounded by indignity and unfairness. And it means that all too often, people are made to suffer or even to pass away alone, denied the comfort of companionship in their final moments while a loved one is left worrying and pacing down the hall.

Janice Langbehn

This has been a very real problem and persistent problem. In February 2007, Miami’s Jackson Memorial Hospital denied Janice Langbehn access to her partner of eighteen years, Lisa Marie Pond, who had collapsed due to a brain aneurysm while preparing to board a cruise ship. For hours, hospital staff refused to allow Janice access even after a legal power of attorney was faxed to the hospital. It was finally a priest who had been called to give last rites who made sure Janice could say her final goodbyes. A social worker at the hospital defended the hospital’s actions, saying that Florida was an “anti-gay state.”

This evening, President Obama called Janice from Air Force One to say he had been moved by her case:

“I was so humbled that he would know Lisa’s name and know our story,” Ms. Langbehn said in a telephone interview. “He apologized for how we were treated. For the last three years, that’s what I’ve been asking the hospital to do. Even now, three years later, they still refuse to apologize to the children and I for the fact that Lisa died alone.”

The memorandum directs HHS to begin the process to issue new rules for hospitals to comply to or risk being denied Medicare and Medicaid payments. The rule-making process could be a lengthy one, requiring the creation and publication of new proposals, a period for public comment and additional approvals. The weakness of this process is that it could be overturned by a future administration, but that overturning would also have to undergo the same lengthy process — creation and publication of a new set of regulations, public comment period, etc. While it is not as immediate as an Executive Order, it is much more robust and durable. And because this proposed rule would provide that any patient — gay or straight — could designate anyone — a partner, trusted friend, a relative who is not necessarily the next of kin — to have access for hospital visitation and make medical decisions on their behalf, it’s hard to see that there would be a significant impetus to overturn this rule.

A federal court in Miami has dismissed a lawsuit filed by a Janice Langbehn, a Washington state lesbian who was not allowed to visit her dying partner at Jackson Memorial Hospital in February 2007.

Lisa Pond suffered an aneurysm just before she, her partner, and three children were about to embark on a family cruise to celebrate Janice and Lisa’s eighteenth anniversary. Pond was rushed to Miami’s Jackson Memorial Hospital, but hospital personnel and social workers refused to allow Langbehn access to pond even after a power of attorney was sent to the hospital naming Langbehn. It was only because of the intervention by a Catholic priest who was called to perform last rites that Langbehn was able to spend a few minutes with Janice before she died.

“The court’s decision paints a tragically stark picture of how vulnerable same-sex couples and their families really are during times of crisis,” said Beth Littrell, Staff Attorney in Lambda Legal’s Southern Regional Office based in Atlanta. “We hope that because of Janice’s courage to seek justice for her family in this case that more people better understand the costs of antigay discrimination. This should never happen to anyone.”

…The court ruled that the hospital has neither an obligation to allow their patients’ visitors nor any obligation whatsoever to provide their patients’ families, healthcare surrogates, or visitors with access to patients in their trauma unit. The court has given the Langbehn-Pond family until October 16 to review the ruling and consider all legal options.

We have always believed and known that the staff at Jackson treats everyone equally, and that their main concern is the well-being of the patients in their care. …Jackson will continue to work with the gay, lesbian, bisexual and transgender community to ensure that everyone knows they are welcome at all of our facilities, where they will receive the highest quality of medical care.

The phrase “everone knows they are welcome” stikes me as perhaps the most cynical statement ever made. If they’ve changed any of their policies since Lisa’s death, I can find no evidence for it. Nor can I find any hint of recongition that they’ve done anything so vile and inhumane as to deny one of their patients the company of their family in their last dying hours. Their behavior toward Janice was outrageous and beyond contemptuous, and they offered not even so much as a “sorry” afterwards.

And to those who claim that marriage doesn’t matter because other legal arrangements are good enough, take a look at Janice Langbehn and her three children. Tell them that they weren’t discriminated against. I dare you.

That’s right. Hospitals denying same-sex couples visitation rights and the ability to make medical decisions for each other can happen even in California.:

[Kristin] Orbin and her partner of 3½ years, Teresa Rowe, 30, who live in Northern California, were in Fresno for Meet in the Middle 4 Equality, an event protesting the California Supreme Court’s ruling upholding Proposition 8.

After marching 14 miles in Central Valley heat, Orbin (who is epileptic) collapsed and suffered three grand mal seizures. A doctor at a first aid center had difficulty finding her pulse, so he called 911.

Orbin said the discrimination started as soon as the paramedics arrived.

“By that time, I was going in and out of consciousness. The paramedics wanted nothing to do with Teresa and she had to practically fight them to be allowed to ride in the ambulance. I remember one of them was very nice and agreed to let her ride with me in the back. Once we got to the hospital, they wheeled me into a hallway and left me, refusing to allow Teresa to be with me.”

The problem with the hospital started when the paramedic informed the emergency room nurse on duty that Kristin was a Meet in the Middle marcher. The nurse didn’t like that.

Fresno Community Hospital and Medical Center refused to accept Kirstin’s medical cards from Teresa, and they refused Teresa’s offer to have their medical advance directives and power of attorney faxed to them. The even refused to accept Teresa’s warning that Kirstin suffered massive migraines if she were given the benzodiazapine Ativan, which they tried to give Kirsten when she woke up. Kirstin was finally able to join Teresa when a doctor arrived a few hours later.

I had hesitated in posting about this when the story appeared because there was only one news source for it. But now that the American Civil Liberties Union has investigated and found that there is considerable merit to the allegations. In fact, because Kirstin has epilepsy, trips to the hospital is fairly normal. In a statement from the ACLU, Teresa said:

“Unfortunately, because Kristin suffers from epilepsy, trips to the hospital are pretty common for us, which is why we filled out the legal paper work to make sure I would be able to be with her and make emergency decisions about her care. But the hospital wouldn\’t let me see Kristen and ignored my advice about her treatment. They ended up giving her the exact medication I repeatedly asked them not to give her.”

The ACLU and the National Center for Lesbian Rights sent a joint letter (PDF: 624 KB/5 pages) to the hospital today urging that it adopt policy changes with regard to same-sex relationships. It cites California’s Unrih Civil Rights Act, which provides that “no matter what their sex, race, color, religion, ancestry, national origin, disability, medical condition, marital status or sexual orientation are entitled to the full and equal accomodations, advantages, facilities, privileges, or services…” The letter requires Fresno Community Hospital to take the following steps before June 22, 2009:

Adopt a comprehensive visitaiton policy that:

Affirms all patients’ rights to have visitors, explicitly including same-sex partners and their children;

Outlines a clear process for determining when visitors will be restricted and how that decision will be communicated; and

Includes a grievance procedure in the case of visitation denial that can be acted on quickly in an emergency situation.

If there was any question before, there’s none now. The state of Utah now vies with Alabama, Mississippi and South Carolina as among the worst states in the nation for LGBT citizens. A Utah House legislative committee found that the very simplest of provisions for designating a partner with the power of making medical decisions or visitation rights was just way too radical.

That’s right. Simply allowing a partner to visit a loved one in the hospital is a threat to marriage. Obviously.

It’s hard to believe that in this day a hospital will block someone from seeing their partner, especially when all of the medical powers of attorney paperwork are in place and properly signed and notarized. It’s harder still to believe that such a hospital would continue to defend its inhuman policies.

The case began in February, 2007, when Janice Langbehn and her partner Lisa Marie Pond, with three of their four children, were in Miami, Florida preparing for a cruise to celebrate their eighteenth anniversary. But before the cruise could leave port, Lisa Marie suffered a massive stroke and was taken to Jackson Memorial. Hospital personnel refused to let Langbehn into Pond’s hospital room, even after a legal power of attorney was faxed to the hospital. Pond was pronounced dead of a brain aneurysm about eighteen hours after being admitted to the hospital. The only time Langbehn was allowed to see her partner was when a priest was giving her last rites.

At one point, a hospital social worker callously defended the hospital’s actions be saying that Florida is “an anti-gay state.” Anti-human would be more like it.

Janice filed a federal lawsuit against Jackson Memorial charging hospital employees with negligence and “intentional infliction of emotional distress.” The suit seeks damages in excess of $75,000. On Friday, Janice’s attorneys from Lambda Legal were back in Miami federal court to argue against a motion filed by the hospital seeking to dismiss the case

“We are here to ensure that families get the respect they deserve at Jackson Memorial Hospital and to prevent Janice’s tragedy from happening to anyone else,” said Beth Littrell, an attorney for Lambda Legal, a national group that fights for the civil rights of gays. “This family deserves to have it’s day in court.”.

Jackson Memorial Hospital is a public hospital operated by the Public Health Trust on behalf of the Miami-Dade Board of County Commissioners. It is also affiliated with the University of Miami as a teaching hospital.

They’re tentatively calling it a domestic-partner registry, but the only proposed benefit from the registry is to ensure that partners are granted visitation rights in city hospitals. Anti-gay activists often concede that “of course” they find such measures to be entirely reasonably — until, that is, an actual measure is proposed. Now anti-gay extremists are coming out of the woodwork, raising the false claim that private contracts can take care of the job. Yeah? Tell that to Janice Langbehn’s family.

In February 2007, Ms. Langbehn, her partner Lisa Marie Pond, and three of their four children were in Florida preparing for a cruise to celebrate their eighteenth anniversary. But before the cruise could leave port, Ms. Pond suffered a massive stroke and was taken to Jackson Memorial. But hospital personnel refused to let Langbehn into Pond’s hospital room, even after a legal power of attorney was faxed to the hospital. Pond was pronounced dead of a brain aneurysm about eighteen hours after being admitted to the hospital. The only time Langbehn was allowed to see her partner was when a priest was giving her last rites.

Langbehn filed a federal lawsuit in Miami on Wednesday charging hospital employees with negligence and “intentional infliction of emotional distress.” The suit seeks damages in excess of $75,000. You can read Janice’s account of the ordeal here.

This is why marriage is so important. Hospitals like Jackson Memorial claim that because Langbehn wasn’t Ponds “immediate family,” they could ignore all evidence of their actually being one — even when presented with a legal power of attorney that anti-gay activists claim would make everything “equal” but separate.

Opponents to gay marriage routinely claim that gay couples can get all the legal protections of marriage through other means. Well that’s a crock:

Four months ago, Lacey resident Janice Langbehn, her partner Lisa Pond and their children Katie, David and Danielle, ages 10 to 13, were set for a relaxing cruise from Miami to the Bahamas.

But Pond, Langbehn’s partner for nearly 18 years, was stricken in Miami with a brain aneurysm and died. The family says the way they were treated by hospital staff compounded their shock and grief.

Langbehn, a social worker, said officials at the University of Miami, Jackson Memorial Hospital did not recognize her or their jointly adopted children as part of Pond’s family. They were not allowed to be with her in the emergency room, and Langbehn’s authority to make decisions for Pond was not recognized.

Here’s the kicker:

After Pond was taken to the emergency room, Langbehn said she was informed by a social worker that they were in an “anti-gay state” and that they needed legal paperwork before Langbehn could see Pond. Even after a friend in Olympia faxed the legal documents that showed that Pond had authorized Langbehn to make medical decisions for her, Langbehn said she wasn’t invited to be with her partner or told anything about her condition.

That’s right. Even with all of the legal paperwork in hand (and even though a straight couple would not have to show any sort of proof), Janice still wasn’t allowed to make any medical conditions, or even to sit alongside her partner as she lay dying. It took a Catholic priest to finally intervene as he administered last rites.

The doctors’ attitudes suddenly changed when they discovered that Lisa was an organ donor candidate. But since her death, the hospital reversed course again. The still haven’t given Janice Lisa’s medical records, and the county hasn’t provided her Lisa’s death certificate, items needed for their two children’s Social Security benefits.

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